Provider Demographics
NPI:1245655356
Name:HEIN, JAMIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:HEIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:LUCAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1020 KABEL AVE
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-3918
Mailing Address - Country:US
Mailing Address - Phone:715-361-2805
Mailing Address - Fax:
Practice Address - Street 1:1020 KABEL AVE
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-3918
Practice Address - Country:US
Practice Address - Phone:715-361-2805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3150-57103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist